Monday, January 05, 2004

Liberals decide two-tier health care OK after all
By Paul Willcocks
VICTORIA - The Liberals' bizarre flip-flop on private health care raises some serious doubts about the soundness of their plans.
Health Minister Colin Hansen took criticism from his own backbenchers for his bill upholding the Canada Health Act. But it's important for the law to be enforced, he said, pledging to end two-tier care which allows families with money to get treatment, while those without wait.
The bill was drafted by ministry staff, made it onto the legislative agenda, was debated, passed and given Royal Assent by Lieutenant Governor Iona Campagnolo.
Doctors were angry when the legislation was introduced. They even talked about a "medical Gestapo" being created by the Liberals. Hansen maintained repeatedly that this law would not affect any doctor or clinic operating legally under the Canada Health Act. The act says access to medically necessary care shouldn't depend on ability to pay. That's all B.C. was ensuring, he said.
But then the legislative session ended before Christmas, and everything changed.
Premier Gordon Campbell said the government will likely never put the law into effect. Less than three weeks earlier, this had been vital legislation, needed to preserve equal access to health care. Now it was dumped.
It takes money to prepare and pass a bill. Why did the Liberals spend your money if they didn't really want the law?
This particular act also worsened already rocky relations with the province's doctors. And it resulted in hundreds of scheduled procedures in private clinics being cancelled, during the brief period when clinics thought they might have to follow the Canada Health Act.
There's been no real explanation. Some Liberals are claiming the bill was only passed because Ottawa threatened to withhold transfer payments unless B.C. moved against two-tier health care. Maybe Paul Martin won't be so tough, says Campbell.
But that's not really an explanation. Martin's leadership win wasn't a shock. (And in any case, he rejects Campbell's claim. "We are never going to two-tier health care," he says.)
What did happen?
Maybe the government wrote and passed a law that it didn't understand.
Maybe it didn't realize just how far two-tier medicine had spread in B.C., and wasn't ready to cope with the problems caused when people were no longer able to avoid waiting lists.
Or maybe, under pressure both from those people and the clinics, the Liberals are abandoning their commitment to equal access to health care.
The Canada Health Act is simple. Provinces must have health care systems that incorporate four principles" - public administration, access to needed medical care in a reasonably timely way, fair payment to doctors and equal access for all Canadians.
We've made it law that a family's chance for needed medical care shouldn't depend on how much money they have.
The kind of two-tier care that Campbell now supports violates that principle. If you have money, you can get quick care. If you don't, you suffer, both physically and economically. Last month, the Liberals thought that was wrong. This month, they don't.
We all make mistakes. But this odd exercise came as the BC Supreme Court found the Liberals broke the law by trying unilaterally cutting payments for medically necessary lab tests.
It all suggests a certain panic and lack of long-term thinking. That's now what's needed.
The health care system is not in any short-term 'sustainability' crisis. Real per capita health spending has risen an average four per cent per year in B.C. since 1990, substantial but not a crisis. We spend about the same as the Canadian average. And across Canada health care spending this year will be 10 per cent of GDP, virtually unchanged from a decade ago.
Few would dispute the need for reform. But we have the time to do it right. Passing laws, and then abandoning them days later, suggests that's not happening.
Footnote: Quick - what's NDP leader Carole James' position on health care? Her ability to answer that question will do much to determine the NDP's fate in next year's election. Health care will go badly for the Liberals this year. But James still has to show that the NDP can do better before voters have any reason to leave the Liberals.

Political games, power and money a dangerous mix
By Paul Willcocks
VICTORIA - Five years ago Erik Bornman was playing at politics, the prime minister in the model Parliament held at the B.C. legislature during Christmas week.
Now he's a big wheel in the federal Liberal party's B.C. wing, safely snuggled in the Martin camp. He's worked in Ottawa as a political aide, and has a day job as a lobbyist in Vancouver.
Bornman is also among those whose offices were searched as part of the criminal investigation that's touched both the federal Liberal party and the provincial legislature.
Just because police search your office or home doesn't mean you've done anything wrong. Bill Cunningham, federal Liberal party president in B.C., said he's disturbed by speculation that the party is somehow involved.
The speculation isn't surprising. It is troubling.
There's little surprise partly because the links with the federal Liberals are so strong. Police searched the offices of Dave Basi, a top aide to Finance Minister Gary Collins, and Bob Virk, who does a similar job for Transportation Minister Judith Reid. Both men are also key federal Liberal organizers.
Bornman was Martin's chief B.C. organizer and is on the party's national executive. Police also asked for documents from Mark Marissen, another Martin organizer and head of the federal Liberal election campaign. (And the husband of Education Minister Christy Clark.) And they searched the home of Bruce Clark, the education minister's brother and a big Martin fundraiser.
Besides being federal Liberal workers and Martin supporters, they've got a lot in common. They're all youngish men who started off in politics as student Liberals; most have never really done anything else.
I admit to a prejudice against young Liberals. (Not as sharp a prejudice as an editor I worked with, who claimed their motto should be "No shirt too young to stuff.") At 17 or 18, I expect people to be passionate about changing the world, not career politics. I always fear young Liberals are people with a bit too much of an eye on the main chance.
But I worry much more about the way the destructive ethos of student politics - it is, ultimately, just a game - is being carried over into the real world. The federal Liberals in particular have turned politics into a big-money, high-stakes slugout, with the spoils - jobs and power - going to those who are the most clever and ruthless at twisting the democratic process.
So riding associations anticipating a normal candidate selection meeting suddenly find themselves facing 600 instant Liberals, all backing the same candidate, all signed up by the same aggressive young men. Someone like Herb Dhaliwal gets too outspoken and a team of Martin operatives swoop down and take control of his riding association.
All clever. All legal. All damaging.
The people who thrive in such a world are the clever, ruthless and power-seeking.
The federal Liberals didn't invent such practices. But they used to be kind of shameful. Now, they're seen as tactical triumphs, with stories of outrageous behaviour taking on the quality of folklore.
The trend has been accelerated by the vast amounts of money now swirling around politics, which have allowed more people to make backroom politics a career. They choose a party and a patron early on, then move through a succession of government, party and lobbying jobs.
Paul Martin had a paid staff of more than 40 for his leadership campaign. He raised $12 million, primarily from big business and the wealthy — about $11 million more than he needed. His fund-raising total for an effectively uncontested leadership campaign was greater than the party's fund-raising for its 2001 national election campaign.
That kind of money changes politics, and not for the better. And given the public's willingness to suspect something is rotten before any real facts about the current investigation are available, there's a lesson emerging from this for the Liberals and every other political party.
Footnote: The provincial Liberals misjudged the reaction to the raids, with Campbell, Collins and Reid all trying to stay on holidays out of the country as the searches made national headlines. Collins eventually changed his mind and came back. Campbell's absence, in the face of a major crisis in public confidence, was a mistake.